Liver Questions! (#askliver)

To ask your liver related question(s): add the #askliver hashtag & tag @LiverQs on your post. Created & maintained by Liver Fellow Network (@liverfellow)

[Russell Rosenblatt @rrosenblattmd]

It is rec'd to NOT start GLP-1's in pts on Resmetirom. I think ALMOST EVERY pt w/ F2-3 MASH will have a stronger indication for GLP-1 than Resmetirom. What would you start 1st?
@IanARowe @ebtapper @SonalKumarMD @DBrandmanMD
https://t.co/L7gweA87G3

[Karn Wijarnpreecha @KarnJUVE]

#livertwitter pt 70 yo F BMI 19, on simvastatin and hx of hypothyroid found to have severe fatty liver. Peth neg. I checked leptin 1.0 (normal 4.7-23.7). Could this be fam partial lipodystrophy syndrome? Any thoughts? @VilarinhoSilvia @DrLoomba @DrHuangDQ

[Naveen Reddy @DrReddyGI]

How often do you test for covert/minimal hepatic encephalopathy?

40% incidence seems high, but it depends on testing.

https://t.co/zOouV0oD2z

#livertwitter #GITwitter @ebtapper @AtoosaRabiee @DrCynthiaLevy @DrHarryThomas @GI_Pearls @AmJGastro @AASLDtweets @stevenbollipo

[Karn Wijarnpreecha @KarnJUVE]

#livertwitter have you seen HBV DNA > 10,000 with HBsAb positive with titer 59.4 mIU/mL? HBeAb positive. Why HBV DNA positive with HBsAb positive?
@DrHuangDQ @doctornikkid @LizzieAbyMD @HowardTLeeMD #HBV

[Anand V Kulkarni @AnandVKulkarni2]

Completely asymptomatic donor (spouse) on evaluation found to have ALP of 285 U/L (ULN-98). Normal GGT . Calcium 11.8 me/dl. Otherwise all routine labs normal. What to do next? @LiverFellow @LiverQs @sonalasthana @DeepikaDevuniMD @pummy92 #livertwitter #transplanttwitter

[Yuval Patel @yuvalpatelMD]

~45 yo with etoh related hepatitis, Lille day 4 responder to prednisolone, no hx adrenal axis issues, ascites prn lvp, minimal diuretics w/ hypoNa

#livertwitter #gitwitter @rabataller @ebtapper @singal_ashwani @Dr_Vijay_Shah

After a month of prednisolone, do you:

[Naim Alkhouri @AlkhouriNaim]

Common scenario in hepatology clinics these days, 75 yo F w PBC has been on Urso 20 years now w ALK Phos 200, Bili 0.3, LSM 5 kPa. What would you do?? @DrCynthiaLevy @CymaBay @IpsenUS @PBCers @KowdleyMd

[Pierre Gholam @pgholam]

#livertwitter how do you plan to assess response to rx with #rezdiffra ?

@PerspectumGroup @MadrigalPharma @PerspectumGroup @SiemensHealth

[Rohit Mehtani @RohitMehtaniDM]

Hey #livertwitter

Do you do liver biopsy before starting steroids in patients with alcohol-associated hepatitis (AH)?

[Brian T Lee MD @briantleemd]

Been awhile Twitter aka X!

Consult today: lactobacillus in the ascitic fluid of a cirrhotic patient with SBP. Takes probiotics at home.

I’ve only seen this one other time during residency. Probiotics in cirrhosis - thoughts? #LiverTwitter

[Liver Fellow Network @LiverFellow]

Check out this essential learning by @JTGrady02 in our Back to Basics post on Outpatient Management of Cirrhosis, complete with a checklist!

#livertwitter #GItwitter #primarycare #MedEd #FOAMed #InternalMedicine

https://t.co/NAS98pKlFv

[Lizzie Aby, MD @LizzieAbyMD]

For #HCC surveillance post liver #transplant, are there any scoring systems that your center uses to help frame risk of recurrence + determine surveillance frequency and duration?

#livertwitter

[Lizzie Aby, MD @LizzieAbyMD]

A question recently came up about serum AFP testing pre- & post-liver transplant (LT) -

If serum AFP is < 10 ng/mL pre-LT (and the patient never had an elevated AFP), would you check their AFP post-LT when evaluating for post-LT recurrence?

Any data you use to support this?

[Liver Fellow Network @LiverFellow]

Interested in joining an LFN initiative? We are looking for a few liver-loving GI or Transplant Hepatology fellows interested in medical education to write practice TH Board Questions! Apply 👇

🗓️ Deadline: February 11
https://t.co/T8uoG9HsR5

#livertwitter #GITwitter #MedEd

[Anand V Kulkarni @AnandVKulkarni2]

Symptoms - occasional pain abdomen. What’s the Diagnosis ? ⁦@LiverQs⁩ ⁦@LiverFellow⁩ ⁦@drkeithsiau⁩ ⁦@RoyAHep⁩ ⁦@ChengHanNg⁩ ⁦@drnipunverma ⁦@KailashKolhe⁩ #livertwitter #GITwitter

[Russell Rosenblatt @rrosenblattmd]

In someone who seroconverted from HBsAg+ to HBsAb+ over 1 year ago with no fibrosis, when do you recommend stopping HCC surveillance?
#livertwitter @LTxJournal @LizzieAbyMD @HowardTLeeMD @BrettEFortuneMD @aly_kaplanMD

[Anand V Kulkarni @AnandVKulkarni2]

@DrAnuraagJ @RoyAHep @MaiwallRakhi @DrArunKValsan @stevenbollipo @juanpabloarab @ebtapper @IJGJournal @LiverFellow @LiverQs @ChengHanNg @_LTSI_
Do you use albumin in hospitalised decomp cirrhosis patients with hypoalb?
Please be truthful. #livertwitter

[Russell Rosenblatt @rrosenblattmd]

How often do you do a colonoscopy on a 25 yo with PSC WITHOUT IBD and NO GI symptoms? @PSCPartners @PSCSupportUK @PSCPartnersCa @ebtapper @DrLiver @AutoImmuneLiver @CholestasisDoc @serperm @AveshThuluvath @LTxJournal @LizzieAbyMD

[Liver Fellow Network @LiverFellow]

Overwhelmed by all the lectures and sessions at #TLM23? LFN created a guide for high-yield and ‘hep-interested’ trainee targeted sessions to help create your agenda! See you in Boston!

[Dalbir Sandhu, MD, FACG, FASGE @drdalbir]

Post esophageal variceal banding do you routinely give PPI for post banding ulcer prophylaxis?
-#GITwitter #livertwitter #liver @drkeithsiau @stevenbollipo @ebtapper @LizzieAbyMD